Hepatic Actinomycotic Abscesses: Diagnosis and Management

Wong, Jeffrey J.; Kinney, Thomas B.; Miller, Franklin J.; Rivera-Sanfeliz, Gerant

doi:10.2214/ajr.04.1691

Cited by 42 publications

(45 citation statements)

References 6 publications

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“…It is also very difficult to distinguish the lesions from ordinary bacterial abscesses or malignant tumors on CT or magnetic resonance imaging, because the findings of both modalities are usually nonspecific and non-diagnostic (6,7,(12)(13)(14). We attempted to evaluate the lesions of hepatic actinomycosis using CEUS several times.…”

Section: Discussionmentioning

confidence: 99%

Refractory Primary Hepatic Actinomycosis with Direct Infiltration to the Diaphragm and Thorax: The Usefulness of Contrast-enhanced Ultrasonography

Shibata

Hiura

et al. 2014

Intern. Med.

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An 80-year-old man was admitted to our hospital with a diagnosis of primary hepatic actinomycosis determined based on a percutaneous aspiration biopsy. The abscesses and state of liquefaction were easily and effectively visualized on contrast-enhanced ultrasonography. Ampicillin/sulbactam was administered; however, lesions of hepatic actinomycosis suddenly infiltrated the diaphragm and right thorax six months later. A drainage tube was inserted into the right thoracic space, and the pleural effusion gradually decreased. The patient received continuous antibiotic therapy for nearly two years and remained free of hepatic actinomycosis on follow-up more than one year later.

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Section: Discussionmentioning

confidence: 99%

Refractory Primary Hepatic Actinomycosis with Direct Infiltration to the Diaphragm and Thorax: The Usefulness of Contrast-enhanced Ultrasonography

Shibata

Hiura

et al. 2014

Intern. Med.

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“…ulcer lesion, causes the disease. Among the abdominal organs, liver, gall pathways, pancreas, gastro intestines and kidney are involved [2] . The differential diagnosis includes malignancies (such as sarcoma and cholangiocarcinoma), ameboma, inflamma- tory bowel diseases (such as diverticular disease, intestinal tuberculosis and Crohn's disease) and pathological status within the abdominal muscles [6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

“…Although in case 2 in our series actinomycosis was highly suspected from our experience with our first case, surgical extirpation was eventually mandatory due to refractory nature of this case. In fact, the majority of patients shows an increased rate of recurrence after antibiotic therapy without simultaneous surgical resection of the infected area; thus combined therapy of antibiotics and surgery has been advocated as the most efficient treatment [2,6] . In such a situation, a laparoscopic approach would be the best option because of its minimal invasiveness.…”

Section: Discussionmentioning

confidence: 99%

“…The abdomen is the most frequent site for actinomycosis and when an abdominal tumor presents as the clinical symptom, the local lesion needs to be differentiated from abdominal tumors of other etiologies, malignancy in particular. Preoperative diagnosis is usually difficult with the majority of cases being diagnosed after the histological and bacteriological examination of the resected specimen [2][3][4][5] . We herein report on two cases which were treated with a combination of antibiotics and surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment for abdominal actinomycosis: A report of two cases

Hayashi¹,

Asakuma

Tsunemi³

et al. 2010

WJGS

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Since actinomycosis sometimes causes an abdominal tumor which mimics malignancy, treatment strategy varies from case to case. We herein report two cases which were treated with a combination of antibiotics and surgical intervention. Both patients presented with an intra-abdominal tumor lesion mimicking malignant disease after an appendectomy for acute appendicitis. Case 1 received surgical extirpation of the abdominal tumor in the liver and kidney twice since the clinical diagnosis of actinomycosis was not made. In contrast, case 2 was successfully treated by a combination of antibiotics and laparoscopic surgery following the experience of case 1. When a high probability diagnosis can be made, a laparoscopic approach is a useful and effective option to treat this condition.

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“…Any site of body can be affected by actinomycosis, but hepatic involvement is rare. Hepatic actinomycosis is usually secondary to other intraabdominal infections, and primary hepatic actinomycosis only accounts for 5% of all actinomycosis cases [2]. Diagnosis of hepatic actinomycosis is frequently missed because of its indolent and slowly progressive characters, and nonspecific clinical and radiologic manifestations treatment consist of penicillin and drainage of the abscesses.…”

Section: …………………………………………………………………………………………………… Introduction:-mentioning

confidence: 99%